Flu 2019/20 - Clinical FAQ's
What about vaccination of patients taking anticoagulants or with a bleeding disorder?
Individuals on stable anticoagulation therapy, including individuals on warfarin who are up to date with their scheduled INR testing and whose latest INR was below the upper threshold of their therapeutic range can receive intramuscular vaccination. If in any doubt, consult with the clinician responsible for prescribing or monitoring the individual’s anticoagulant therapy. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/special-situations.html#bleeding
What if you are unsure if a patient has already had a flu vaccination?
If there is nothing documented, then the patient should be offered a flu vaccination. An additional dose is unlikely to cause them any harm. Any adverse reactions are likely to be similar to any other person receiving one dose of the vaccine.
What about patients who have recently been diagnosed with the flu?
These patients should be offered the vaccine. Both the inactivated flu vaccine and the LAIV can be given at any time following recovery providing there are no contraindications to vaccination and the patient is not acutely unwell.
What about patients who have an existing medical condition?
Please refer to the NHSE document Inactivated influenza vaccine information for healthcare practitioners on medical conditions (pg. 14) and for egg allergies Chapter 19 in the Green Book.
attenuated intranasal flu vaccine and other live vaccines.
Does a GP have to be on the premises when the flu clinic is running?
The short answer is No.
However, the GP should be aware that if they delegate flu vaccinations, they are still responsible for patients' overall care. They must ensure the healthcare professional administering the flu vaccines has the relevant knowledge, skills and experience to carry out the procedure and be able to deal with an emergency arising from that.
Practice Nurses should only work within their levels of competence and we would suggest that as long as they have access to a GP, which could be by phone, this should be sufficient.
You do need to ensure someone else is also available who can provide assistance if there was a medical emergency i.e. BLS trained, which most staff will have undertaken.